Analysis on the treatment compliance of patients with androgenetic alopecia and its influencing factors: based on the comparison between microneedle therapy and drug therapy

Abstract

The aim of this study is to analyze treatment adherence and its influencing factors in patients with androgenetic alopecia (AGA). Clinical data from 156 AGA patients, including 89 males and 67 females, were collected. The patients were assigned to either medication group (n = 86) or microneedling group (n = 70). Treatment adherence was assessed using the Morisky Medication Adherence Scale (MGL). Additional data on the patients’ basic information, annual income, education level, side effects, treatment efficacy, disease severity, and mental health (anxiety and depression) were also recorded. Univariate and multivariate analyses were used to identify factors associated with treatment adherence. The results showed that patients in the microneedling group demonstrated significantly higher treatment adherence compared to those in the medication group (P = 0.032). Within the microneedling group, adherence was significantly associated with age, education level, annual income, treatment duration, and side effects (P < 0.05). Specifically, patients over the age of 30, those with higher incomes, higher educational levels, and those with treatment durations of less than 3 months exhibited better adherence. Additionally, both treatment efficacy improvement and reduced anxiety were strongly correlated with better adherence (P < 0.001, P = 0.010). In the medication group, side effects and treatment efficacy were significant factors influencing adherence (P = 0.001, P < 0.001). Logistic regression analysis revealed that, within the microneedling group, patients with at least a middle school education or higher (OR = 0.031, P = 0.035; OR = 0.016, P = 0.041) and those who experienced improved treatment outcomes (OR = 0.002, P = 0.006) were more likely to adhere to treatment. On the other hand, the occurrence of side effects significantly increased the likelihood of non-adherence (OR = 92.358, P = 0.019). Patients with more severe conditions were more likely to adhere to treatment (OR = 0.035, P = 0.038). In the medication group, those with stable or improved treatment outcomes showed better adherence (OR = 0.004, P = 0.010; OR = 0.005, P = 0.012). However, patients with more severe conditions were more likely to discontinue treatment (OR = 204.058, P = 0.029), and depression was identified as a significant risk factor for non-adherence (OR = 586.074, P = 0.004). Microneedling therapy demonstrates significant advantages in improving patient adherence, particularly by reducing side effects, enhancing perceived treatment efficacy, and improving mental health. Treatment efficacy and side effects are key determinants of treatment adherence, with patient age, education level, and income also playing an important role. Future studies should further explore the long-term efficacy and safety of microneedling therapy across different patient populations to optimize treatment protocols and improve adherence.